=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225110604
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GALLI PODIATRIC FOOT AND ANKLE ASSOCIATES,P.C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2006
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 CENTRAL PARK W SUITE 1R
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10023-7253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-262-4588
-----------------------------------------------------
Fax | 212-247-1403
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 CENTRAL PARK W SUITE 1R
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10023-7253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-262-4588
-----------------------------------------------------
Fax | 212-247-1403
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES./OWNER
-----------------------------------------------------
Name | DR. LOUIS C GALLI
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 212-262-4588
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | N002529
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------